Position Summary: This role focuses on monitoring and analyzing reports for a single hospital to ensure SLA/KPI compliance. The Market Director identifies trends, implements solutions to ensure client satisfaction, owns reporting, and provides support to the CFO.
Key Responsibilities:
- Responsible for the preparation and completion of eReserve.
- Analyze eReserve data and key trends affecting net revenue, and contribute to the revenue section of the month-end Performance Summary.
- Monitor, analyze, and track AR disputes, providing timely resolution.
- Review and approve manual adjustments, refunds, and revenue reclassifications.
- Evaluate proposed Managed Care Contracts, identifying concerns or issues prior to finalization.
- Assist in confirming accurate loading of contract terms into MedAssets and appropriate claim adjudication during/after managed care negotiations.
- Monitor billing, AR, and reconciliation processes for hospital-specific contracts.
- Collaborate with hospital departments to address revenue cycle challenges (e.g., orders, charging, Patient Access, DNFB, DNSP, QS, disputes).
- Work with hospital leadership to resolve revenue cycle issues.
- Facilitate revenue cycle meetings, including preparation, execution, and follow-up.
- Support and coordinate various meetings, such as Leadership, Chart Audit, Compliance, Charge Master reviews/updates, and Complex Case Reviews. Oversee hospital revenue cycle initiatives (e.g., GZ, Bad Debt), assist with audits, and engage Legal on collection issues.
- Act as the point of escalation for customer service matters.
- Serve as an internal consultant to hospital revenue departments, ensuring accurate charge collection, billing techniques, and adherence to guidelines.
- Direct the preparation or supervision of the Charge Master for hospitals, establishing proper review/update procedures.
- Anticipate procedural changes and advise revenue departments to ensure compliance with external and internal guidelines.
- Coordinate with Case Management and Medical Records on patient classification issues.
- Keep the CFO and/or Compliance Director informed of any compliance or financial system concerns.
- Promote a professional, respectful workplace culture, supporting a culture of safety.
- Perform additional duties as assigned.
Skills and Certifications:
Bachelor's degree (business, health administration, or related field required)
8 years of experience in A/R management or managed care contracting and analysis
8 years directing a multi-facility business office
Security Clearance Required: Yes
Visa Candidate Considered: No